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目的对比高频超声与传统临床检查方法对类风湿性肩关节炎诊断的差异性,评价超声的诊断价值。方法 27例类风湿性肩关节炎患者,应用高频超声检查对经临床和实验室检查确诊的肩关节进行扫查,观察肩关节腔腋囊侧及后隐窝侧、肩峰下滑囊、肱二头肌长头肌腱鞘4个区域内滑膜厚度、积液深度;利用彩色多普勒观察滑膜血流显示情况。结果 5例患者出现肱二头肌长头腱肌腱炎表现,其声像图表现为肌腱肿胀,纹理紊乱,可见片状低回声,肌腱滑膜增生,腱鞘积液,彩色多普勒血流显像(CDFI)于部分病例可见较多短线状及树枝状血流信号。9例患者出现滑膜炎表现,其声像图表现为肩关节可见滑膜增生,CDFI显示部分增生的滑漠内可见较多点状及短线状血流信号。6例患者出现关节腔积液表现,其声像图表现为关节腔内可见不规则液性区。12例患者出现骨侵蚀表现,其声像图表现为骨表面连续性中断。不规则隆起,可见于关节的任何部位。2例患者出现肩袖病变,其声像图表现为肌腱肿胀、纹理紊乱、中断,内可见不规则低回声区,部分可见强回声钙化灶。结论高频超声检查可发现类风湿性肩关节炎早期病变,对疾病的早期诊断有重要价值。
Objective To compare the diagnostic value of high frequency ultrasound and traditional clinical examination in the diagnosis of rheumatoid arthritis in the shoulder and to evaluate the diagnostic value of ultrasound. Methods Twenty-seven patients with rheumatoid arthritis of shoulder were examined with high-frequency ultrasonography on the shoulder joint confirmed by clinical and laboratory examinations. The shoulder joint cavity on the axillary and posterior recess, Biceps tendon sheath biceps tendon sheath in four regions of the thickness of the synovial fluid, effusion depth; the use of color Doppler flow synovial flow showed. Results The biceps tendon tendonitis appeared in 5 patients. The sonogram showed swelling of the tendon, disordered texture, hypoechoic flaps, synovial hyperplasia of the tendon, effusion of the tendon sheath, color Doppler flow imaging Like (CDFI) in some cases can be seen more short-shaped and dendritic blood flow signal. Nine patients had synovitis, and the sonogram showed synovial hyperplasia in the shoulder joint. CDFI showed more dot-like and short-line blood flow signals in the gliding part of the hyperplasia. 6 patients showed joint effusion performance, the sound image showed intra-articular irregular liquid region can be seen. Bone erosions occurred in 12 patients, and the sound image showed discontinuity in the continuity of the bone surface. Irregular bulge, visible in any part of the joint. Two patients had rotator cuff disease. The sonogram showed swelling of the tendon, disordered texture and disruption. The irregular hypoechoic area was visible in the two cases, and the echogenic calcification was partially seen. Conclusion High-frequency ultrasound can detect early lesions of rheumatoid arthritis and has important value in the early diagnosis of the disease.